Treatment of human viral infections

- Burroughs Wellcome Co.

Treatments of AIDS or humans carrying or infected with the AIDS virus or having antibodies to the AIDS virus is disclosed using the compound 3'-azido-3'-deoxythymidine or a pharmaceutically acceptable basic salt thereof.Also disclosed is the use of the 5'-mono-, di- and triphosphate of 3'-azido-3'-deoxythymidine or a pharmaceutically acceptable basic salt thereof for the same purpose.

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Description
EXAMPLE 1 Preparation of 2,3'-Anhydrothymidine

Thymidine (85.4 g; 0.353 mol) was dissolved in 500 mL dry DMF (dimethyl formamide) and added to N-(2-chloro-1,1,2-trifluoroethyl)dielthylamine (100.3 g; 0.529 mol) [prepared according to the method of D. E. Ayer, J. Med. Chem. 6, 608 (1963)]. This solution was heated at 70.degree. C. for 30 minutes then poured into 950 mL ethanol with vigorous stirring. The product precipitated from this solution and was filtered. The ethanol supernatant was refrigerated then filtered to yield a total of 47.75 g (0.213 mol; 60.3%) of 2,3'-anhydrothymidine mp=228.degree.-230.degree. C.

EXAMPLE 2 Preparation for 3'-Azido-3'-deoxythymidine

2,3'-Anhydrothymidine (25 g; 0.1115 mol) and NaN3 (29 g; 0.446 mol) was suspended in a mixture of 250 mL DMF and 38 mL H.sub.2 O. The reaction was refluxed for 5 hours at which time it was poured into 1 liter of H.sub.2 O. This aqueous solution was extracted with ethyl acetate (EtOAc) (3.times.700 ml). The EtOAc was dried over Na.sub.2 SO.sub.4, filtered, and then EtOAc was removed in vacuo to yield a viscous oil. This oil was stirred wtih 200 mL water resulting in a solid, 3'-azido-3'-deoxythymidine, 9.15 g (0.0342 mol; 30.7%) mp=116.degree.-118.degree. C.

EXAMPLE 3 Preparation of Sodium Salt of 3'-Azido-3'-deoxythymidine

Approximately one gram of 3'-azido-3'-deoxythymidine was dissolved in 50 mL of distilled water. The pH was adjusted to 12 with 1N NaOH. Approximately half of the solution was freeze dried. A white powder, the sodium salt of 3'-azido-3'-deoxythymidine on the 0.6 hydrate, 0.415 g, resulted.

Analysis calculated for C.sub.10 H.sub.12 N.sub.5 NaO.sub.4.6/10 H.sub.2 O.

Calculated: C,40.03; H,4.43; N,23.34; Na,7.66.

Found: C,39.88; H,4.34; N,23.29; Na,7.90.

EXAMPLE 4 Preparation of 5'-Monophosphate of 3'-Azido-3'-deoxythymidine

3'-Azido-3'-deoxythymidine (0.5 g, 1.87 mmol) was dissolved in 5 mL of triethyl phosphate and the mixture was cooled to -5.degree. C. Phosphorus oxychloride (0.685 mL, 7 mmol) was added in one portion to the rapidly stirred solution which was then maintained at -10.degree. C. for 22 hours. An aliquot was removed and added to concentrated ammonium hydroxide. Analysis of this sample of TLC (cellulose n-PrOH:H2O, 7:3 v/v) showed no remaining starting material and a single fluorescent spot with lower mobility than the nucleoside. The reaction mixture was poured onto 20 mL of ice and water. This was placed in an ice bath and the pH of the solution was adjusted to a value of 7.5 by the addition of 2N NaOH. The basic mixture was extracted once with chloroform and once with ether. The aqueous layer was again adjusted to give a pH of 7.5 and concentrated in vacuo to remove residual organic solvent. The material was stored at -10.degree. C. until purified as follows:

Deactivated charcoal was prepared by washing coconut charcoal (50-200 mesh, 100 g) with 500 mL of 1 N HC1, 3 L water, 35 mL of 3% toluene in 95% ethanol, 600 mL of 95% ethanol and finally extensively with water. Deactivated charcoal (12 mL of settled wet charcoal) was added with stirring to the monophosphate solution (0.72 g, 1.8 mmol, 30 mL). The supernatant was decanted and the charcoal was washed with 150 mL of water. The nucleotide was eluted from the charcoal by washing with 120 mL of 1.5 M ammonium hydroxide in 50% ethanol. This solution was filtered through a 0.22 micron filter, concentrated in vacuo to 10 mL, filtered through a Amicon Centriflo CF-25 membrane, and lyophilized. The yield of diammonium 3'-azido-3'-deoxythymidine-5'-monophosphate was 0.36 g (0.94 mmol, 52%). This compound was characterized as a nucleoside 5' -monophosphate by the ability of 5'-nucleotidase to degrade it to the nucleoside.

EXAMPLE 5 Preparation of the 5'-Di- and Triphosphate of 3'-Azido-3'-deoxythymidine

The di- and triphosphate of 3'-azido-3'-deoxythymidine were prepared from the ammonium salt of the 5'-monophosphate of 3'-azido-3'-deoxythymidine by a four step sequence.

Step I - Preparation of Bis-(Tri-n-butylammonium) Pyrophosphate

A column of DOW 50 pyridinium resin was prepared by pouring 40 mL of resin into a 25 cm diameter column and washing with water until no more color eluted. Sodium pyrophosphate decahydrate (1.12 g, 2.51 mmol) was dissolved in 30 mL of water and applied to the column. The column was eluted with water. A 125 mL fraction of the eluant which contained UV absorbing material was collected. The volume was reduced to 10 mL in vacuo and tri-n-butylamine (1.2 mL) was added. The volume was reduced in vacuo and the residue was dried by coevaporation with pyridine four times. The product was stored in a freezer (-5.degree. C.).

Step II - Preparation of the Acid Form of the Monophosphate of 3'-Azido3-deoxythymidine

The acid form of the monophosphate was prepared by passing the ammonium salt (0.1 g, 0.283 mmol) dissolved in 6 mL of water, through a 1.5 mL (10 eq.) column of DOW 50 H+.

Step III - Preparation of Phosphoromorpholidate Derivative

The hydrogen form of the monophosphate, 0.283 mmol, was dissolved in 9 mL of water. Morpholine (99 .mu.L, 1.12 mmol, 4 eq.) was added and the solution heated to reflux. Dicyclohexyl carbodiimide (0.234 g, 1.13 mmol, 4 eq.) dissolved in t-butanol (5 mL) was added over a three-hour period. The reaction was refluxed overnight. The reaction was cooled to room temperature, filtered, and the solvents removed in vacuo. Ethanol was added and evaporated in vacuo four times. The residue was dissolved in methanol and the phosphoromorpholidate precipitated by the addition of ether. The precipitate was triturated with ether four times and dried on a rotary evaporator. A weight yield of 97 mG, 50%, was obtained.

Step IV - Preparation of the 5'-Di- and Triphosphate of 3'-Azido-3'-deoxythymidine

The phosphoromorpholidate derivative was dried by removal of pyridine in vauco four times. The bis-(tri-n-butylammonium) pyrophosphate was also dried by removal of pyridine in vacuo. The phosphoromorpholidate was dissolved in pyridine, 5 mL, and added to the vessel containing the pyrophosphate reagent. The reaction was allowed to continue overnight at room temperature. The pyridine was removed in vacuo. Water was added to the residue and removed in vacuo three times. The residue was frozen.

The reaction mixture (0.09 g) was thawed and dissolved in 50 mL of water. The solution was applied to a column (1.times.10 cm) of DEAE Saphadex A-25 which had been equilibrated 50 mM ammonium bicarbonate. The phosphates were eluted with a 300 mL linear gradient of 50-800 mM ammonium bicarbonate. The fractions containing the diphosphate nucleotide were pooled as were those containing the triphosphate nucleotide. The pooled diphosphate and triphosphate fractions were each dried in vacuo, redissolved in water, dried again, redissolved in water and lyophilized. The yields were: the diphosphate as the triammonium salt, 0.014 g; the triphosphate, as the tetrammonium salt, 0.002 g.

EXAMPLE 6 Enzymatic Synthesis of the 5'-Triphosphate of 3'-Azido-3'-deoxythymidine

The 5'-triphosphate was synthesized from the 5'-disphosphate using pyruvate kinase and nucleoside diphosphate kinase. The reaction mixture contained: 6 mM 3'-azido TDP, 12 mM adenosine triphosphate, 40 mM MgC12, 40 mM potassium piperazine-N,N'-bis(2-ethanesulfonic acid) PIPES buffer, pH 6.8), 30 mM phosphoenolpyruvate, 40 IU/ml nucleoside diphosphate kinase and 100 IU/ml pyruvate kinase in a final volume of 5 mL. The reaction mixture was incubated at 37.degree. C. for 5 days. The reaction mixture was applied to a column (2.5.times.10 cm) of AEAE Saphadex A-25 which had been equilibrated with ammonium bicarbonate. The nucleotides were eluted with a gradient of 100-1000 mM ammonium bicarbonate. Fractions containing the triphosphate were pooled, and evaporated to dryness in vacuo. The compound was further purified using a preparative HPLC column (Whatman, Inc., Magnum 9 SAX) eluted with a gradient of 10-1000 mM potassium phosphate, ph 3.5. The resulting compound was further purified using a DEAE Saphadex A-25 column as above. The fractions containing the tetrammonium 3'-azido-3'-deoxythymidine-5'-triphosphate were pooled, dried in vacuo, redissolved in water and lyophilized to yield 0.008 g (0.01 mmol).

EXAMPLE 7 
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     Tablet Formulation                                                        

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     3'-Azido-3'-Deoxythymidine                                                

                         100 mg                                                

     Lactose             200 mg                                                

     Starch               50 mg                                                

     Polyvinylpyrrolidone                                                      

                          5 mg                                                 

     Magnesium stearate   4 mg                                                 

                         359 mg                                                

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Tablets were prepared from the foregoing ingredients by wet granulation followed by compression.

EXAMPLE 8 Capsule

A two part soft gelatin is prepared by placing the tablet formulation of Example 7 in a two part capsule.

EXAMPLE 9 
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     Sterile Injectable Formulation                                            

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     3'-Azido-3'-deoxythymidine  0.125  g                                      

     Sterile, pyrogen-free, pH 7 phosphate buffer, q.s. to                     

                                 25     ml                                     

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The formulation is sterilized by heat and the placed in a sealed container, e.g., glass so that it may be administered by infusion or by injection.

EXAMPLE 10

The acid forms of the 5'-mono, di- and triphosphate nucleotides of 3'-azido-3'-deoxythymidine are prepared by passing the corresponding ammonium salts through DOW 50 H+ columns and lyphilizing the solutions obtained thereby.

Claims

1. A method of treating a human having HTLV III virus infection comprising administering an effective HTLV III virus infection treatment amount of the 5'-monophosphate of 3'-azido-3'-dexoythymidine to said human.

2. The method of claim 1 in which the 5'-monophosphate of 3'-azido-3'-deoxythymidine is orally administered.

3. The method of claim 1 in which the 5'-monophosphate of 3'-azido-3'-deoxythymidine is parenterally administered.

4. A method of treating a human having a HTLV III virus infection comprising administering an effective HTLV III virus infection treatment amount of the 5'-diphosphate of 3'-azido-3'-deoxythymidine to said human.

5. The method of claim 4 in which the 5'-diphosphate of 3'-azido-3'-deoxythymidine is orally administered.

6. The method of claim 4 in which the 5'-diphosphate of 3'-azido-3'-deoxythymidine is parenterally administered.

7. The method of claim 4 in which said salt is orally administered.

8. The method of claim 4 in which said salt is parenterally administered.

9. A method of treating a human having a HTLV III virus infection comprising administering an effective HTLV III virus infection treatment amount of the 5'-triphosphate of 3'-azido-3'-deoxythymidine to said human.

10. The method of claim 9 in which the 5'-triphosphate of 3'-azido-3'-deoxythymidine is orally administered.

11. The method of claim 9 in which the 5'-triphosphate of 3'-azido-3'-deoxythymidine is parenterally administered.

12. The method of claim 1, 4 or 9 in which the human has AIDS or AIDS related complex.

13. The method of claim 1, 4, or 9 in which the human has antibodies to the HTLV III virus.

14. A method of treating a human having HTLV III virus infection comprising administering an effective HTLV III virus infection treatment amount of a pharmaceutically accepable salt of the 5'-monophosphate of 3'-azido-3'-deoxythymidine to said human.

15. The method of claim 14 in which said salt is orally administered.

16. The method of claim 14 in which said salt is parenterally administered.

17. A method of treating a human having a HTLV III virus infection comprising administering an effective HTLV III virus infection treatment amount of a pharmaceutically acceptable salt of 5'-diphosphate of 3'-azido-3'-deoxythymidine to said human.

18. A method of treating a human having a HTLV III virus infection comprising administering an effective HTLV III virus infection treatment amount of a pharmaceutically acceptable salt of the 5'-triphosphate of 3'-azido-3'deoxythymidine to said human.

19. The method of claim 18 in which said salt is orally administered.

20. The method of claim 18 in which said salt is parenterally administered.

21. The method of claims 14, 17 or 18 in which the human has AIDS or AIDS related complex.

22. The method of claims 14, 17 or 18 in which the human has antibodies to the HTLV III virus.

Referenced Cited
Other references
  • Krieg et al., Exp. Cell Res., 116:21-29, 1978. Lin et al., J. Med. Chem., 26:1691-1696, 1983. De Clercq et al., Biochem. Pharm., 29:1849-1851, 1980. Ostertag et al., Exp. Cell Res., 116:31-37, 1978. Mitsuya et al., PNAS, 82:7096-7100, 1985. Ostertag et al., PNAS, 71:4980-4985, 1974. Riesenberg, JAMA, 254:2521, 2527, 2529, 1985. Robins, Chem. & Eng. News, 64:28-40, 1986. FDA Drug Bull., 15:29 and 31, 1985. The Lancet, 1:957-958, 1987.
Patent History
Patent number: 4847244
Type: Grant
Filed: Oct 20, 1987
Date of Patent: Jul 11, 1989
Assignee: Burroughs Wellcome Co. (Research Triangle Park, NC)
Inventors: Janet L. Rideout (Raleigh, NC), David W. Barry (Chapel Hill, NC), Sandra N. Lehrman (Durham, NC), Martha H. St. Clair (Durham, NC), Phillip A. Furman (Durham, NC)
Primary Examiner: John W. Rollins
Attorneys: Donald Brown, Lawrence A. Neilsen
Application Number: 7/110,947